Dr. Howard Smith Oncall

Vidcast:  https://youtu.be/ZrOvE10t_D0   Last week in several reports I detailed the complex relationship between the angiotensin system and our current coronavirus.  A new, in-depth analysis of this relationship from collaborators at Harvard’s Brigham and Women’s Hospital, the University of Minnesota, and the University of Glasgow was just published in the New England Journal of Medicine.   The bottom line for most people on these medications: sit tight and consult your physician.  Yes, CoVid19 does use the ACE2 on cells to invade them.  ACE inhibitors and Angiotensin Receptor Blockers increase this substance in the body and animal studies suggest a risk for CoVid19 infection.   However, there is no conclusive humandata from the Chinese CoVid19 experience to say thumbs up or down.  These medications are lifesaving for those with heart failure, and they should absolutely not consider switching at this time. For those on the drugs for blood pressure control, the decision to switch is up to you and your doctor.

  Vidcast:  https://youtu.be/dF2PiV88UfY   The handles on these pitcher may sudden fracture creating a laceration hazard.  Stop using the pitcher and contact the company at 1-800-451-8217 for a full refund.   https://www.cpsc.gov/Recalls/2020/Crate-and-Barrel-Recalls-Glass-Pitchers-Due-to-Laceration-Hazard   #recall #crateandbarrel #pitcher #glass #laceration  

  Vidcast:  https://youtu.be/4-WniVYZog4   These walkers, model number X002,  fail to meet federal safety standards.  They fit through a standard door but have no safeguards that enable them to stop at the edge of a stair.  They also have leg openings large enough to entrap a child’s head at the neck.  These deficiencies can lead to serious injuries, falls, or death.   Do not allow your baby to use this device.   Dismantle it and dispose of it safely.  This item was exclusively sold by Amazon.  Contact Amazon for a refund.   https://www.cpsc.gov/Recalls/2020/kids-and-koalas-baby-walkers-recalled-due-to-fall-and-entrapment-hazards-sold     #recall #kidsandkoalas #walker

x Vidcast:  https://youtu.be/StE8YcHckFs   Kids Concepts is recalling Lilly of New York Children’s Winter Boots due to toxic lead levels in this product.  This boot is sold exclusively on zulily.com.  Don’t permit children to wear them, and contact the company at 1-888-359-1322 for a replacement or refund.   https://www.cpsc.gov/Recalls/2020/Lilly-of-New-York-Childrens-Winter-Boots-Recalled-by-Kidz-Concepts-Due-to-Violation-of-Federal-Lead-Content-Ban-Sold-Exclusively-at-Zulily-com-Recall-Alert   #recall #winterboot #lilly #zulily #lead  

  Vidcast:  https://youtu.be/eyzNKsNan_E   Thule is recalling its car seat adapters.  The plastic brackets on this product may break and pose a fall hazard to infants.  Stop using this product and contact the company for a replacement or a refund by calling 1-855-652-2688.   https://www.cpsc.gov/Recalls/2020/Thule-Recalls-Thule-Sleek-Car-Seat-Adapters-Due-to-Fall-Hazard   #recall #thule #caradaplterbracket

  Vidcast:  https://youtu.be/5DPOPsDT6fc   Grizzly Industrial is recalling it Children’s Tool Kits for lead and toy safety violations.  The tool belt, hammer, and suspenders contain excessive lead.  The toy goggles and hard hats fail to meet US toy safety standards.   Stop using these toys and contact Grizzly for instructions about returning them for a full refund.  Call 1-888-615-7944.   https://www.cpsc.gov/Recalls/2020/Childrens-Tool-Kits-Recalled-by-Grizzly-Industrial-Due-to-Violation-of-Federal-Lead-Content-Ban-and-Toy-Safety-Requirements   #recall #grizzly #toolkit #children

  Vidcast:  https://youtu.be/2S43UFK2S1Q   Kawasaki USA has two recalls on its Off-Highway Utility Vehicles.   Recall #1 is for steering shaft defect leading to excessive wear, loss of steering control, and a crash hazard. Recall #2 is due to a fire hazard due to two defects.  Debris falling on the vehicles exhaust manifold may ignite.  Frozen water can block the vehicle’s breather hose permitting an oil leak.  Both issues pose a fire hazard. Consumers should stop using this vehicle and contact the company at 1-866-802-9381 to arrange free repairs.   https://www.cpsc.gov/Recalls/2020/Kawasaki-USA-Recalls-Off-Highway-Utility-Vehicles-Due-to-Crash-Hazard-Recall-Alert https://www.cpsc.gov/Recalls/2020/Kawasaki-USA-Recalls-Off-Highway-Utility-Vehicles-Due-to-Fuel-Leak-Fire-Hazards-Recall-Alert   #recall #kawasaki #offhighway

  Vidcast:  https://youtu.be/cisBEkcOKHE   Woom Bikes USA is recalling its bike due to a defective front fork.  It can loosen and detach leading to a fall and injury.   Contact Woom for a free repair kit by calling 1-855-966-6872.   https://www.cpsc.gov/Recalls/2020/Woom-bikes-USA-Recalls-Bicycles-Due-to-Fall-and-Injury-Hazards-Recall-Alert   #recall #woom #bicycle

  Vidcast:  https://youtu.be/JAqMDvfE6wI   A slew of products have been recalled by the Consumer Product Safety Commission this week since they fail to meet child safety standards.  These include: — Plant Therapy’s Wintergreen Essential Oils and Essential Oil Blends with Wintergreen — Earth Sonnets Wintergreen Essential Oil — Earthroma Wintergreen Essential Oil — Belle Chemical Sodium and Potassium Hydroxide Products — Boyer. Sodium and Potassium Hydroxide Products  — Novartis Sandimmune and Neoral Blister Packs — Numbskin Pain Relief Cream   Return these products to the point of purchase.   https://www.cpsc.gov/Recalls?page=1   #recalls #childpackaging  

  Vidcast:  https://youtu.be/caWeC8yVPFI   Tiffany Food Corporation of Brooklyn, NY is recalling its Huanfushanzen Huang Mountain Tea Mushroom dried mushrooms.  This product may contain undeclared sulfites.  Those will a sulfite sensitivity or allergy may develop a severe reaction after eating this product. Product was sold in FL, OH, CA, and MA. Return this product to the store for a full refund.  If you have questions, call the company at 1-347-627-8588.   https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/tiffany-food-corp-issues-alert-undeclared-sulfites-huangfushanzen-dried-mushrooms   #recall #huangmountain #mushroom #sulfites

  Vidcast:  https://youtu.be/HLkdVvOkQzE   Guan’s Mushroom Co. of Calfornia is  recalling its Enoki Mushrooms from Korea.  These may well be contaminated with Listeria.   If you eat contaminated product, you are likely to develop a severe, life=threatening gastrenteritis, and that’s particularly likely if you are very young, old, or have a weakened immune system.  Even young, healthy individuals will get high fever, headache, nausea, cramps, and diarrhea.  Pregnant women may miscarry. This product was sold in CA, NY, and PA. Return the product to the store for a full refund.  Questions to the company at 1-323-223-1188.   https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/guans-mushroom-co-recalls-enoki-because-possible-health-risk   #recall #enoki #mushroom #listeria  

  Vidcast:  https://youtu.be/Y26LDEEM0Kg   Coronavirus infected individuals do not shed live virus in their tears.  Researchers at Singapore’s National University Hospital studied 17 patients with the virus.   Their tears were disease free by both viral cultures and RP-PCR genetic tests.  At the same time, their noses and throats were swarming with infectious CoVid19.   While you can’t spread virus via your eyes, you can contract disease via this route.   If viral-laden droplets from an infected person’s nose or throat get into your eyes, your tears will transport live virus into your nose, throat, and respiratory tract.  Then the game is lost.   Keep your hands spotless and away from your nose, mouth, and eyes.    Ivan Seah Yu Jun, Danielle E. Anderson, Adrian Eng Zheng Kang, Lin-Fa Wang, Pooja Rao, Barnaby Edward Young, David Chien Lye, Rupesh Agrawal. Assessing Viral Shedding and Infectivity of Tears in Coronavirus Disease 2019 (COVID-19) Patients. Ophthalmology, 2020; DOI: 10.1016/j.ophtha.2020.03.026   #

  Vidcast:  https://youtu.be/NQxpwpddiYs   Those pretzels, chips, and pasta sauce may weaken your immune defenses against bacteria and viruses including CoVid19.  Immunologists at Germany’s University of Bonn trace the effects of your liberal self-shaking on your host defenses.   When you eat abundant salt, your kidneys seek to flush it out to maintain a safe concentration around your cells.  In so doing, glucocorticoid steroid levels in your body rise, and these steroids suppress your immunity.  Their studies in both mice and men confirm this effect.   Given our current coronavirus epidemic, you can’t afford to given an advantage to invading viruses or bacteria.  Cut out the salty foods and gorge on fruits and vegetables as you social distance.    Katarzyna Jobin, Natascha E. Stumpf, Sebastian Schwab, etal. A high-salt diet compromises antibacterial neutrophil responses through hormonal perturbation. Science Translational Medicine, 2020 DOI: 10.1126/scitranslmed.aay3850   #covid19 #coronavirus #salt #immunit

  Vidcast:  https://youtu.be/98zOq9ZpG9M   TPA, the clot busting tissue plasminogen activator that rescues heart attack and stroke patients, may help ventilator-dependent CoVid19 patients in respiratory failure.  Researchers at MIT, Harvard teaching hospitals, and the University of Colorado believe that TPA can prevent extensive blood clotting that exacerbates CoVid19 patients’ respiratory failure.   Clinicians on the front lines of the coronavirus battle in New York and Europe report that infected patients clot too easily and have damaging clots not only in their lungs but also in their hearts and kidneys as part of multi-organ failure.   A federally-funded clinical trial of TPA will deliver the drug intravenously and via direct airway instillation.  Genentech is donating the drug.    Hunter B. Moore, Christopher D. Barrett, Ernest E. Moore, Robert C. McIntyre, Peter K. Moore, Daniel S. Talmor, Frederick A. Moore, Michael B. Yaffe. Is There a Role for Tissue Plasminogen Activator (tPA) as a Novel Treatment f

  Vidcast:  https://youtu.be/q66mLjoY-r4   Tocilizumab, a Genentech-Roche drug marketed as Actemra for autoimmune arthritis and cytokine storms induced by CAR-T cell cancer therapy, did successfully squelch CoVid19 immune storm in a preliminary Chinese study.  Researchers there treated 20 patients with severe and critical disease in risk of dying.   The patients received a 9 day course of the drug along with vent therapy.  75% showed improved oxygenation and one patient came off oxygen and 90% showed improved lung CTs. 90% of patients with discharged well.    A worldwide clinical trial coded as COVACTA will begin recruiting 330 patients in April.  The drug, potentially lifesaving, does have serious side effects including gastrointestinal tears, liver toxicity, and cancer   http://chinaxiv.org/abs/202003.00026 https://www.cancernetwork.com/news/fda-approves-phase-iii-clinical-trial-tocilizumab-covid-19-pneumonia   #covid19 #coronavirus #cytokinestorm #covacta #actemra #tocilizumab  

Lindt Excellence 85% Cocoa Chocolate Recalled Vidcast:  https://youtu.be/SlUff4Zowzs   Lindt and Sprüngli USA is voluntarily recalling its Lindt Excellence 85% Cocoa chocolate bars due to improper packaging and labeling.  The product in the wrapper is actually Lindt Excellent Dark Carmel Sea Salt bars.  This contains milk and soy.  Those who have allergies to either may develop and allergic reaction that could be life-threatening.  The Lot is Code L5539 with a best before date of 11/30/2020.  If you have this product, return it to any Lindt store for a replacement.   https://bit.ly/2J6nTmH   #recall #lindt #chocolate #milk #soy  

  Vidcast:  https://youtu.be/Qh5-66RULws   Mountain Rose Herbs is voluntarily recalling its Organic Kudzu Root Herbal Supplement.  This product may have Salmonella contamination.  This bacterium can product a severe gastroenteritis or get into the bloodstream and induce sepsis with heart valve infection, blood vessel infection, or septic arthritis.  The Lots involved are #24247-X and #24247.  This product has been sold in nearly every state and in Canada.  If you have this item, return it to the place of purchase for a full refund.  Info from the company at 1-800-879-3337.   https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/mountain-rose-herbs-recalls-organic-kudzu-root-herbal-supplement-due-possible-health-risk   #recall #kudzuroot #supplement #salmonella  

  Vidcast:  https://youtu.be/9esH8xR_GNA   Elevators: Space on larger elevators and face the wall but don’t lean against it.  If you’re the third on a smaller residential elevator, wait for the next one.  Families count as one if they fit on one wall.  Knuckles, elbows or probes on the buttons please.   Out and about:  In a line? Space 6-10 feet away and get off the line if someone is coughing or sneezing.  Breath shallowly in line or passing people on the street.   When returning:  Immediately wash with soap and water or use hand sanitizer.  Wipe off surfaces of purchased items with soapy sponge or Clorox wipe.   #covid19 #coronavirus #soap #elevator #purell #clorox  

  Vidcast:  https://youtu.be/gBCsEskhjLE   Soap, any kind of soap, disintegrates coronavirus by pulverizing its outer lipid-protein envelope.  It’s fast, and 20-30 seconds in contact with soapy water should do it.   My routine: rubbing with bar or soft soap and water for 20 seconds (2 happy birthday songs) and then leave the soapy water for another 20 seconds.  Don't forget to use soapy water on your phone, your smartwatch or fitness wearable, and let it sit for 20-30 seconds.  Remember, virus lives on surfaces: cardboard 24 hrs, stainless steel 48 hrs, and plastic 72 hrs. so rewash hands if you touch them or coat them down with soapy water for 30 seconds.   https://www.theguardian.com/commentisfree/2020/mar/12/science-soap-kills-coronavirus-alcohol-based-disinfectants   https://www.nejm.org/doi/full/10.1056/NEJMc2004973     #covid19 #coronavirus #soap #cardboard #plastic #stainless

  Vidcast:  https://youtu.be/eL_nvp4v6IY   Why is a ventilator, or a vent as we docs call it, so complicated and expensive.  Isn’t just a pump to drive oxygenated air into a patient’s lungs?   Its pump is electronically controlled to control the numbers of respirations per minute, the volume of air in each respiration, and the percentage of added oxygen.  The ventilator can assist natural breaths or control respirations completely.  For patients with severe lung infections and damage, the vent maintains some residual airway pressure between breaths.    These machines cost as much as $50, 000 each.  A clever Canadian anesthetist has created plumbing so that up to 9 patients with similar respiratory requirements may be serviced by one vent.     https://www.dailymail.co.uk/news/article-8136299/Doctors-turns-one-ventilator-nine-genius-DIY-mechanics.html   #covid19 #coronavirus #ventilator